Physiological and cerebral hemodynamic changes during routine nursing procedures for very preterm infants.

Background: Care procedures for preterm infants can induce stress that may disrupt homeostasis, possibly altering cerebral perfusion or oxygenation. We evaluated the physiological and cerebral oxygenation changes during the routine care of very preterm infants.
Methods: We analyzed the changes in heart and respiratory rates and in systemic and regional cerebral oxygen saturation of 27 very preterm infants, defining three care periods of 5 min each: 30 min before care, 30 min during care, and 30 min after care. Mean maximum and minimum values for each parameter during the defined care periods were compared by analysis of variance (ANOVA) for repeated measures.
Results: The mean heart rate was significantly higher during (160 ± 8 bpm) than before and after care (151 ± 21 and 151 ± 6 bpm, respectively). The mean respiratory rate decreased during care and increased afterward: 44 ± 2.2, 40.6 ± 3.2, and 46.7 ± 3.4 cycles/min, respectively (p < 0.05). The mean regional cerebral oxygen and systemic saturation did not vary significantly. Mean minimum and maximum values for each parameter varied during and after care as compared with before care (all p < 0.01). The mean minimum cerebral and systemic saturation was lower after care than before care: 59 ± 8 % versus 63 ± 8 % and 83 ± 3 % versus 90 ± 7 %, respectively (p < 0.05).
Conclusions: During routine care procedures for very preterm infants, the change in physiological parameters suggested an autonomic stress reaction. Cerebral desaturation may occur during and after the care of such infants and call for specific attention to better support the physiological and cerebral well-being of these infants during standard care procedures.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024. Published by Elsevier Masson SAS.)